Nursing intervention with rationale:1. Inspect skin for changes in color, turgor, and vascularity. Note redness and excoriation. Observe for ecchymosis and purpura.Rationale: Indicates areas of poor circulation and early breakdown that may lead to decubitus formation and infection.

2. Monitor fluid intake and hydration of skin and mucous membranes.Rationale: Detects presence of dehydration or overhydration that affects circulation and tissue integrity at the cellular level.

5. Provide soothing skin care, restrict use of soaps, and apply ointments or creams such as lanolin or Aquaphor.Rationale: Baking soda and cornstarch baths decrease itching and are less drying than soaps. Lotions and ointments may be desired to relieve dry, cracked skin.

7. Investigate reports of itching.Rationale: Although dialysis has largely eliminated skin problems associated with uremic frost, itching can occur because the skin is an excretory route for waste products, such as phosphate crystals associated with hyperparathyroidism in ESRD.